Friday, June 25, 2010

On Wednesday we only scored an 8/8 on the BPP. We didn’t get points for “fetal tone.” Otherwise, everything looks and sounds great; heart rate stayed between 140-150bpm, both during the BPP and later when the doctor used the Doppler. Baby girl had her hands under her chin, as usual. Though a bit later, she made a little fist.She is definitely still a girl and growing well. Surprisingly she measured in the 47th percentile, smaller than before. Though as we all know, ultrasounds aren’t perfect, so I’m still guessing that she’ll be at least 8 ½ pounds. Her current estimated weight is 6-6 ½ pounds.

My usual doctor is out of town this week, so I saw one of her partners, who in addition to being a high-risk OB, has also done a fellowship in reproductive endocrinology. Needless to say, we spent at least half of the appointment discussing infertility and treatment, specifically for auto immune issues.

As it stands, we are scheduled to leave Dublin next summer, which wouldn’t be a big deal, except that we have two frozen embryos that need to be transferred. I want to make sure that if they should implant, wherever I go for follow up care (while in the U.S.) is capable and supportive of providing immune therapy, since obviously, it works. It turns out that the RE/OB I saw today is familiar with the Chicago program in which I had the famous “Chicago bloods” and offered to do some additional research and get back to me. Most of my test results were already in my chart and I told him that I would get additional information as well. All in all, a successful appointment.

Saturday, June 19, 2010

I thought I should probably update the blog since it’s been a long time, too long, and I’ve had three appointments since my arrival, with another scheduled next week.

First, may I just say how nice it is to be back in the land of great medical care, very clean facilities, and specimen cups that are bigger than a sewing thimble. It’s amazing what you take for granted when it’s available all the time, and a normal way of life. I never thought I would miss these things.

appointment 1, 32 weeks 5 days

The staff was awesome and seemed genuinely glad to see me back. I gave my doctor the updates from the previous two months in Dublin, she ordered some blood work, went over my chart, and then we had the big talk.

induction or c-sectionHaving already spoken to several doctors, doing a lot of research, and weighing the pros and cons of both, it seems that going with a scheduled c-section is the best course of action. So, the OR is booked for JULY 15!!!! Just a week earlier than my original due date.

Back to the appointment, the doctor listened to the baby, then did a non-stress test. Much to my surprise, I was having contractions. I didn’t feel them, but the machine was definitely picking them up. The doctor said that the fact that I wasn’t feeling them was a good sign, but that I should take it easy, just to be safe. I was also told that my uterus was “irritable.” My ankles were a bit swollen, so I was ordered to keep my feet up. After the whirlwind move we’d just had, that sounded heavenly. Overall everything was great, including my weight and ever perfect BP.

appointment 2 and first Bio Physical Profile, 33 weeks 4 days

Keeping my feet up worked like a charm, swelling was down, BP and weight were again, perfect.

The Bio Physical Profile is a combination of an ultrasound and non-stress test. Apparently it’s fairly standard for high-risk pregnancy assessment. More info, here.Baby girl had her hand up on her cheek during the ultrasound, took a few practice breaths, and arched her back several times, adorable! The non-stress test portion was easy enough and we scored a perfect 10/10 on our first BPP.

appointment 3 and second Bio Physical Profile, 34 weeks 4 days

My BP was still fine, though I had lost weight, so I was told to eat more. Will do.

My stubborn little girl was uncooperative during the ultrasound portion of the BPP and wouldn’t take a practice breath. The doctor spent a lot of time pressing on her, but no luck. I then went across the hall for the non-stress test. Baby girl’s heart rate was all over the place, though she was fairly inactive, so the nurse brought me ice water to drink in hopes of waking up the baby. It worked. My doctor was pleased with the results, but wanted to do another ultrasound to check for breathing again. She pushed on baby girl, trying to wake her up and make her angry so that she would take a breath. Twenty minutes later, she finally took two practice breaths and we passed, another score of 10/10.

Very sorry for the lack of pictures. I’ll remember to ask at my next appointment. I will say that she’s adorable and loves to have her hands up near her face.

Hope everyone is well. I finally moved into the hotel last week and should have more time to blog and catch up on other blogs!!

Tuesday, June 8, 2010

I had been warned to expect comments, but really, nothing prepares you for the stupid things people say. I have been approached in stores, airports, and even by waitresses in restaurants. It seems that being pregnant invites conversation, wanted or not. Trust me, most of the time, it’s not.

Now, before I go on, I really don’t mind the well wishes, words of congratulations, or even a few questions; it’s the follow up that irritates me.

Always, always, always the first question. Everyone wants to know if it’s a boy or a girl. Fine. It’s a girl. A proper response is “congratulations, how wonderful, you must be so excited.” Anything else will lead me to believe you were raised in a barn, by wolves. I do not want to hear of your disappointment, do not want you to tell me that girls are harder to raise than boys, or that I might be surprised when the baby is born. Seriously? To the last one, I often feel like saying, huh, don’t think so, considering I’ve had over 20 ultrasounds, by 6 doctors (and a few techs), on at least 10 different ultrasound machines and in two countries. I think it’s safe to assume that we are having a girl, and we are THRILLED!

I’ve had people not only ask if I’m having twins, but also again with the “you might be surprised, there might be two”. I’ve not said it, but would love to inform the idiots that we had actually transferred two, one didn’t implant, and yeah, thanks for reminding me. A**.

Then there are the comments about my belly. One person insisted that I must be having a boy because of how I’m carrying the baby. Nope, it’s a girl. Followed by asking several times if I’m sure, see above. Not one week later someone else asked if I knew what I was having and when I answered a girl, was told that, “yes, you look like you’re carrying a girl.” Make up your minds people.

If you are a waitress taking my order in a restaurant, I do not want to know about your surprise pregnancy, how you told your boyfriend the news, or about your labor experience. I especially do not want you to return and share, in detail, your stories of morning sickness, during the salad course.

Then there was the little episode at the Chicago airport. I politely asked the man at the information desk where the closest Starbucks was located. He looked at me, then asked if I “should be going there?” The only response I could muster was that my crack dealer was fine with it. Now, I’m all about pregnant women being careful and taking precautions, but after 10ish hours of travel at 32 weeks, I’m fairly sure that my doctor would be okay with me having one caffeinated drink. I certainly don’t need the judgment from a man working at the information booth in an airport. Plus, as my mom pointed out, Starbucks has a lot of other things besides espresso. No need to be so quick to judge.

(This happened a few days after we moved to the new house. I waited to post until I had arrived in the U.S. and my mom could see that I am fine)

It all started with my grand idea of carrying just one more load of stuff up to the master bedroom before I went to bed. I knew I shouldn’t do it, could have asked for help, etc, etc. No, no, just one more pile of stuff. With both hands full, I started up the final staircase to our room when I tripped. Unfortunately I couldn’t drop anything in time, so no hands to break the fall. My full weight and force hit the edge of the stair, right on my abdomen. I was upset with myself for doing something stupid, that was 100% preventable, and quickly realized that a trip to the ER was the best thing to do. Particularly since ALL of the 20+ pregnancy books I own state that after any fall or jarring motion, a trip to the doctor/ hospital/ emergency room is in order. Unfortunately the health care providers I dealt with that night disagreed.

We arrived at the maternity hospital around 8:45pm and upon checking in, were told to go to the Fetal Assessment Unit, which is also the emergency department after normal hours. After sitting in the waiting area for several minutes, my usually, over the top, patient husband asked me if they knew why we were there and started to get up. I jumped up, walked to the desk, and politely explained the situation. I was then told that we had to wait like everyone else. The midwife on duty asked if I’d felt the baby move since the fall, I had not. Then she sat back and said “Welcome”, as if she were welcoming us to the spa. I was getting angrier by the second.

After several more minutes in the waiting area, the midwife appeared and took us back to the smallest exam room I’ve ever seen. She didn’t have my chart (which I had handed over upon arriving in the unit) and again asked if I had felt the baby move. No. She then had the nerve to ask what I wanted her to do. I calmly told her that I understood that the baby is well-protected, but I would appreciate it if she would check for a heartbeat, then an ultrasound to look at the fluid level and placenta. You would have thought I’d asked her to solve all of the world’s problems. I also requested that she call my doctor, which completely stumped her. I explained that he might want to know that one of his high-risk, “private” patients is in the hospital. The midwife said that the doctor on call would decide if she would call my doctor or not, when she “finally” saw me. She then left in a huff to find a Doppler. Now, I’m not one to panic and don’t get easily excited, but while she was gone, I all but insisted my husband find me a flight out of the country that night (as if that were possible). I was done dealing with the substandard health care and laid back attitudes in that department. As he was on the phone, the midwife returned and snapped at him to get off, as the phone would interfere with the Doppler; I didn’t have the energy to correct her. She was able to find the heartbeat, then asked me to give a urine sample, and off she went. I’m not an invalid, but at 31 weeks pregnant, she could have at least offered to help me off the exam table, especially since I had been lying down for 30+ minutes by that point.

When I returned from the restroom, a nurse stopped by with a fetal monitor to do a non-stress test. Progress, I thought. She strapped on the sensors, explained the machine and different colored lights to my husband, and disappeared. For the next 45 minutes we were left alone. The baby’s heartbeat would often disappear from the monitor, leading my husband to rearrange the sensors; not a peep from the staff.

Eventually the nurse returned and asked about Anti-D (Rhogam). Again, progress; at least they’d finally looked at my chart, saw that I am O-neg, and would need another dose of Anti-D. The nurse said that they would take blood, but I would need to return the following day for the shot. WHAT??? She asked if I was “happy with that?” Err, NO. Why would I be happy about making a second trip for the sole purpose of receiving an injection that EVERYONE knew I needed. Wouldn’t it be easier to just give me the shot while I was already there. Well of course not, because “that’s not how we do it”. She asked several more times if I was happy. I finally explained that we had just moved and that the next day was completely booked with appointments and workers (close to impossible to reschedule). She then had the nerve to ask me what was more important. Clearly my health and the baby’s health are paramount, but that certainly wasn’t the attitude we had received for the past several hours, so no, I was not happy that I had to cancel my day to return for a shot that they could have just as easily given to me that night.

Finally (2 ½ hours after we arrived) the doctor appeared, chart in hand. She was pleased with the non-stress test and offered to do an ultrasound. The midwife had also returned and took blood. Just what I wanted, Ms. Bad Attitude drawing my blood. For whatever reason though, she’d had a complete change of attitude. Perhaps she had read my chart, perhaps it was a divine intervention, who knows. She was cordial and professional, minus not cleaning the draw site with anything. As we left the room, my husband pointed out that my urine sample was sitting on the lid to the garbage bin. Huh, glad it was so important to get a urine sample. Yes, there was a lot of eye-rolling that night, and interesting discussions on what we have to look forward to in the U.S. due to the new health care bill (Another post, another time).

Bloods taken, we then moved to another room for the ultrasound. The doctor began by cooing over what a cute baby we have and pointing out her nose, chin, etc. While I appreciate the attempt, what I was most interested in was the fluid level and state of the placenta. Fortunately, everything was fine. The doctor left for several minutes, then returned to tell me that she had just spoken to my doctor. Yeah, I’m sure he was thrilled to be called at 11:45pm for an update on a patient that had arrived almost three hours before. She said that he was pleased with what had been done, that I didn’t need to be admitted overnight (thank goodness), that I should follow up the next day for the Anti-D injection, and that he would see me at my already scheduled appointment in a few days.

Around midnight it was finally time to go. I was told that my chart would be waiting for me the following day in the outpatient unit and that I should return around 1pm. As if it would be that easy....

I spent the next morning on the phone canceling afternoon appointments, then made my way back to the hospital, arriving 15 minutes early for my injection. I attempted to check in at the front desk in the outpatient department and was told that they didn’t have my chart and that I should have it. Back and forth for 10 minutes, explaining that I had been in Fetal Assessment the previous night, still no chart. I was told to go down the hall and find a midwife. Fabulous, here we go again.

A very nice midwife approached me and after a few minutes of searching, found my chart. I was then handed over to a nurse who I found to be not only professional, but very pleasant. Good thing, because she had to break the news to me that the bloods taken the previous night were LOST. Lost as in never made it to the lab. Lost as in they couldn’t give me the injection until more blood was taken and then processed in the lab, which would take at least three hours. I asked if the blood work could be rushed. Blank stare at the word “rushed”, but at least an apology and promise that the blood would be taken to the lab and handed over directly.

After making a few phone calls to vent about the latest, I walked around the hospital, wondering if my plane ticket for the U.S. had been purchased; I was D.O.N.E. I arrived back in the outpatient unit and the wonderful nurse said that the blood work was back. She administered the injection then mentioned that I was welcome to go to Fetal Assessment for another ultrasound. I told her that after my experience the previous night, I would have to decline. She apologized, then offered to have the doctor in the outpatient unit do an ultrasound. I told her that I would really appreciate that and would find it very reassuring, particularly since we were heading into the weekend. A fabulous doctor soon appeared, READ the chart, asked questions, did an ultrasound, asked more questions, and made notes in the chart. ::blink, blink:: We had a nice conversation, she handed me my chart, and said that I should come back in if anything changes. What a difference! An attitude like that would have gone a million miles with me the night before.

To top off my annoyance and disappointment with the Fetal Assessment Unit, please notice the comments the midwife made in my chart.

Yes, that says, “parents anxious.” I’m also rolling my eyes about being seen “right away.” Clearly our definition of “right away” is very different.

Again, fortunately everything is fine. When I saw my doctor a few days later, we discussed the situation in Fetal Assessment and he wrote in my chart that if I'm admitted anywhere for anything, he's to be called immediately. I also learned that had I been brought in by ambulance, he would have been called right away because I'm a private patient. I certainly didn't think the fall was ambulance worthy, but at least I understand the system now. Things are just done differently overseas, very, very differently.

Monday, May 31, 2010

Yes, I’m stateside. I have very mixed feelings about it, but I’m here. I really, really struggled with the decision of staying in Ireland versus delivering in the U.S., but then the “powers that be” got involved, and the decision was essentially made for me. It would have been FAR easier to stay in Ireland, but the “powers that be” were not comfortable with me delivering outside of the U.S., so here I am. I pushed and pushed to stay in Dublin as long as possible, but eventually it was time to go. In fact, I’m fairly sure the RMO was ready to personally escort me to the airport if I asked to extend my stay in Dublin one more time.

Overall, travel was easy. Well, as easy as can be with 14+ hours of airport and flight time and an injection, at 32 weeks.

I miss my husband and cats terribly, but I have to trust that we’ve done the right thing.

Saturday, May 22, 2010

Many apologies for the long silence. To say that I’ve been busy is the understatement of the century. Moving, unpacking, no internet, work related events (husband), social events, appointments, and a few unexpected trips to the hospital (baby and I are fine).

Unfortunately this coming week will be just as crazy as the last. Please give me another week to take care of a few things and I promise A LOT of updates, and pictures, soon.

The cats were sequestered in an upstairs bathroom during the move last week. They had ‘some’ of the comforts of home, a cat box, food, water, favorite blankets, etc.. It was fairly quiet, an occasional meow from Bella, but overall, quiet.

Around 1pm, the movers had gone outside to have lunch, my husband was in the kitchen, I came around the corner and saw Bella walking down the stairs. “CATS”, I yelled. I wasn’t sure if Guinness had already made it through the foyer to the open front door or not. My husband came running; I chased Bella back up the stairs, and MUCH to my relief, saw Guinness dash into the master bedroom. Bella quickly followed him in, then the little miss had the nerve to turn around and hiss at me, likely knowing that I was there to capture her and return her to the bathroom.

My husband had secured the doors on the main floor, then ran up to assist with the cat catching. Bella went into a guest room, where she was quickly rounded up. Guinness stayed in the master bedroom and darted in and out from behind boxes, until he too was finally captured.

Both cats were returned to the bathroom with a guard (my husband) posted at the door. Yeah, I had forgotten that Guinness knows how to open door handles and let himself out.

Friday, May 14, 2010

I’ll be honest, today is a lot harder than I thought it would be. I’ve had four major moves in the last five years, five if you count Scottsdale to Washington state, prior to moving to Germany. Six, seven, or eight moves if you count Belarus to Lithuania, then Lithuania to the States, then the U.S. to Ireland, after we were PNGd. Needless to say, I’m something of a moving aficionado at this point.

For moving, I have a system. The system involves packing my own linens and clothes, the use of spreadsheets and lists, and lots and lots of organizing and cleaning. Unfortunately since the actual “we found you a new residence” and “you can move next week” came rather suddenly, my system was a bit shot. Add in that we have no household help and I’m 30 weeks pregnant, my system is REALLY shot.

This is a HUGE problem for someone that survives and thrives on organization and control. Yes, I know, then why in the world did I marry into the FS, another topic, another post. Anyway, for this move, I’ve had to put down my tape gun, shout a farewell to my colored Sharpies, and I’m fairly certain that my husband has hidden my spreadsheets. NOT fun.

Just in the past week, I’ve had no fewer than 10 people tell me that I’m not allowed to pack, help, or chase around the movers with my lists (for which I’m sure they’re thankful). The “powers that be” have called several times and told me that in my “condition” I need to sit on the couch and relax. Of course I agreed, only to put the phone down and start another list. What I hadn’t planned on was a husband who would actually take the day off and stay home to supervise the move, and me. This is a first; he’s usually stuck at work during pack-outs. So here we are, me typing away on my laptop, him perched at the other end of the couch (between me and the doorway no less), watching me out of the corner of his eye. I’m trapped, really trapped. The loss of control is hard.

Three months ago, a nice man from the moving company came to do a preliminary inventory and give an estimate, “just in case” we decided to move. Two weeks ago he came back to do another inventory, and to drop off some boxes and tape, you know, because I was going to pack. Hey, good intentions.

Five minutes before his second visit, I had been told that instead of just taking our personal items, we were now supposed to take the furniture we wanted, too. I called the “powers that be” to confirm, and told yep, take the furniture. Unfortunately nobody had bothered to inform the moving company, so when the nice man arrived, he had to re-do the bid. He said that with the added furniture he would either need an additional day or more men. “MORE MEN”, I just about shouted. He said that he would speak with the “powers that be” and that the movers would be here on the arranged date.

This morning four men arrived. “Ummmm,” I said as I nervously peeked outside hoping to see at least three or four more. Nope. As soon as they walked through they told us that this would be a two-day move. NO!!!!! Unfortunately yes. I don’t know who dropped the ball. It was either the “powers that be” or the moving company. Either way, we were prepared for boxing, loading, moving, unloading, un-boxing, done. Now it’s going to be boxing, loading, boxes spend the night in the truck, truck comes back tomorrow, unloading, un-boxing.

I ran upstairs, err, I walked up carefully, grabbed a toothbrush and other toiletries, change of clothes, then went to the kitchen to rescue cat dishes and food before they were packed.

Wednesday, May 12, 2010

For you non FS readers, that’s the Foreign Affairs Manual, aka, the bible of the Foreign Service. Yes, I have a new rule that should be included, a rule that many would actually find useful.

If you haven’t used it, read it, listened to it, watched it, or worn it in the past five years, you don’t need it and shouldn’t be hauling it all over the world. Especially true if you’ve told your spouse that she can’t have certain things because your HHE (household effects) is already over the weight limit.

This brought to you by the pre-move boxing up that it currently taking place in my house.

Monday, May 10, 2010

Some women sew curtains, some women scrub the floors, some women re-organize the kitchen cabinets, I, move to a new house. Yes, one of the situations mentioned in some of my rather cryptic posts has finally been resolved. I didn’t want to say anything until it was signed, sealed, and delivered, but now that everything is official, I’m THRILLED to announce that we are moving, on Friday. This, is the ultimate in nesting.

The good and the bad.

First the bad….I’ve been busy, busy, busy lately, too many appointments and commitments. That means that the normal cleaning, organizing, and packing I do before a “typical move”, (I’ll wait while you FS readers laugh at ‘typical move’) hasn’t been done. The movers will be here bright and early on Friday morning and nothing is ready. EEP!

We are also losing the biggest garage/ basement/ ultimate storage area I’ve ever seen in a FS residence. So of course I’m now scrambling to find things to throw away, donate, or send back to the States. Fortunately the embassy is taking donations for a local charity and my husband has already taken one full SUV load over. I haven’t yet broken the news to him that there is another load, or two, to take.

There is also a teeny-tiny time crunch. I have approximately three weeks to pack, move, unpack, organize, set up the new house, etc, before heading back to the U.S. (more on that later).

Now, the good news...The new residence is about ½ a mile from the current house, so it’s not like we won’t see our stuff for 3+ months. This will be the easiest FS move ever. I’m hoping that the movers will gently box up our things, transport everything the short distance, and voila, done.

Aside from a major lack of storage, the new house seems perfecto! My husband’s commute to work is still a mere hop, skip, and jump, the neighborhood is lovely, and the house has been very well maintained (from what we’ve seen).

So goodbye electricity issues, goodbye plumbing problems, and goodbye mold. New house, we’ll be there on Friday!

Wednesday, May 5, 2010

Just let me complain for a minute, then I’ll stop. I have tried very hard to avoid posting about pregnancy related issues. There are many infertile women who read the blog and I know how painful it is when women “on the other side” complain about pregnancy, so I’ll keep this brief. Or, feel free to ignore. Trust me, I understand, and ((HUGS)).

The heparin injections are getting more difficult by the day. I can’t begin to tell you how many clothes have been ruined, money has been spent, and tears have been shed. My body has just about had it. During my last week in the U.S., I had finally run out of room on my stomach (or so I thought), and started injecting into my thighs. Upon my return to Dublin, my husband somehow found some remaining space on my stomach, so we are back to doing injections there.

Heparin stings, A LOT. It’s much worse than Clexane, Innohep, and Lovenox, or so I’ve been told, by everyone. Unfortunately the doctors will not let me switch to the low-weight molecular stuff, so on I go with heparin. In addition to initial sting, the tissue underneath often continues to burn for hours after the injection, then it itches. In order to avoid scratching my skin completely off, I’ve been using Benadryl cream and lotion several times a day. Oh, and then there’s the little issue of running out of inject sites. Most of the tissue is so damaged and hard underneath my skin, that even if I manage to get the needle through, upon withdrawing it, the heparin often comes squirting back out and I have to start again.

And the clothes…. Heparin is a blood thinner, so mix a needle, some thin blood, and clothes, and you have a mess. I usually walk around holding tissue on my stomach for up to 30 minutes, or until the bleeding stops, but the sites often bleed again within an hour, or even the next day. Bandaids aren’t an option because I’m allergic to latex and even the latex-free bandaids irritate my skin, a lot. Let’s just say, we go through gallons of OxiClean, other stain removers, and bleach at my house. My clothes are blood stained every.single.day. On the good days it’s just little specks, on the bad days it looks like I’ve murdered someone, violently.

From what I’ve been told by the high-risk OBs, I’ll continue on with two injections a day until delivery (scheduled because of the heparin), get a 12 hour break, then another six weeks of shots.

Counting down the days……

Thanks for letting me vent. Carry on with your regular scheduled, and less messy, blogging.

Friday, April 30, 2010

Today is our fifth wedding anniversary. We are still very much in love, wonderful friends, and enjoying our marriage. I couldn’t ask for more. I’m truly blessed and looking forward to the rest of our lives together.

It is also an anniversary of great sadness. Two years ago today we were PNGd from Belarus. You can read this previous post for the full story. I keep hoping that as time passes, I will begin to forget and forgive, but I’m just not there yet. For those of you in the FS, may you never, ever have to live through such a horrible experience.

Thursday, April 29, 2010

This is not looking good. I finally received a response from Company B regarding the insurance fiasco I’ve been dealing with since January. I almost didn’t open the email as there was no indication that it was from Company B or had any affiliation with, and the subject was just bizarre. “*********three letters********” And the three letters were completely random.

Against better judgment, I opened it, fortunately. Yes, I opened it and read such things as

“We have received notification from our Marketing Department that you are requesting assistance in getting overseas claims processed due to the fact that Ireland does not bill medical services or provide the same information that is required for claims submitted in the United States.”

Why it went through the Marketing Department is beyond me, though I probably shouldn’t be surprised. I suppose I should be grateful that they finally grasp that Ireland doesn’t bill for services the way physicians in the U.S. do, but isn’t that the point of paying for “overseas coverage?”

Another gem:

“We do understand that services rendered overseas are handled differently than in the United States; however, ‘Company B’ is required to administer the contract as it is written.”

Contract as written, what???? I don’t care what they claim their contract says. In the paperwork that I have, nowhere does it say that overseas providers must handle billing similarly as is done in the U.S. Again, isn’t that the point of “overseas coverage?” They finally acknowledge that services and payment are handled differently “overseas.” Clearly I’m missing something as to why they won’t pay these claims.

Well, at least they are no longer asking for CPT codes, but it doesn’t change the fact that they are not going to pay for ANYTHING.

This afternoon I was back on the phone with Company B for 45 minutes. After much back and forth, the woman I was speaking to said that they could at least cover the blood work if I could get a breakdown of dates and blood tests from the lab. Are you kidding me? Was she referring to the same lab that won’t even give me a copy of my blood work results? Yeah, good luck getting a breakdown of services and prices.

Just an FYI, I was speaking to another FS spouse earlier this week and she had the same problem with Company B. Fortunately she had a “normal” pregnancy, obstetric care was less expensive, and her doctor worked with the hospital billing department, so after a year of fighting, she was finally reimbursed. She also delivered here so was reimbursed via the “fund site.” It appears that I won’t be so lucky.

Thursday, April 22, 2010

You know, the story that’s going in the book I plan to write when my husband retires. Which right now, feels like a billion years away.

Today I had meetings, lots and lots of meetings. Unfortunately I can’t share the nature nor the outcome of said meetings, but oh will they ever go in my “tell all” book. There is one situation in particular that has been dragging on since oh, we arrived, 19 months ago. You FS peeps can probably imagine what this pertains to and why I’m the one dealing with it.

To be fair, I’m sure that some of the responsibility lies with me because after the first solid 10 months of dealing with said situation, I backed off, got lazy, felt defeated, whatever you choose to believe. Well, now we’re expecting a baby and I want things done. Personally I think that 19 months is more than enough time, but I’m not in the FS, I’m just a spouse, so what do I know.

In January, some new department heads came in, so I brought the situation to their attention. Then went through the “proper” channels and procedures, and hoped for resolution. Wishful thinking. Then it went to person A, then to person B (both of whom I met with and both of whom had wildly different ideas on policies and procedures). Then department X was brought in, then department Y and Z, add person C, D, and F. Then add two meetings with person F, and jumping through all of the hoops that person F asked for. Well, now enter person G who is dealing with the aftermath that person F left in his/her trail, prior to leaving forever and ever. Goodbye

I will say that my favorite part of all of this has been when people look me right in the face, smile, and tell me to enjoy the pregnancy. Umm, not sure which part I’m supposed to enjoy, dealing with the above situation every.single.day, fighting with Company B for maternity coverage, injecting heparin into my sore, bleeding body twice a day. (Yes, I’m beyond thankful to be pregnant; it would just be a lot more pleasant if life were somewhat normal)

So here we are, no resolution, more meetings scheduled for tomorrow and next week, and true to the FS way, even more people getting involved.

Err, which part of this is fun?

And PS, going to the pharmacy after leaving the meeting only to find out that I need a ****** prescription for baby aspirin did NOT help my already foul mood.

Wednesday, April 21, 2010

This is probably one of those, ‘you had to be there’ situations, but it was so over the top, that I couldn’t not share it with blogland.

One of the reasons for my trip to the U.S. was to buy maternity clothes; ordering online just doesn’t work for some items. I hit the usual stores, Pea In the Pod and Gap Maternity, then headed over to Motherhood Maternity to have a look.

While browsing through the racks, a young (maybe 25ish) woman came into the store and when approached by the saleswoman, loudly announced that she wasn’t pregnant yet, but planned to start trying next year and wanted to buy some maternity clothes. Upon hearing this, my ears perked up and I wanted to scream “RUN, don’t do this to yourself, your body might not cooperate, don’t set yourself up for heartache.” Granted, 3 ½ years of infertility has colored my perspective on “preparing” for life events.

I continued to shop and finally headed toward the dressing rooms to try on a few items. Oh lucky me, Ms. ‘I’m not pregnant yet’ or even trying, went into the room next to mine.

For the next 20 minutes, I tried, and failed, to block out the TMI I heard from the dressing room next door, as did my mom and probably every other sane person in the store. Ms. ‘I’m not pregnant yet’ shared ALL about her life, including, but not limited to, her choice of birth control, her husband’s ex-girlfriend’s choice of birth control and decision to stop taking it without telling him, her house and how old it is, and her debt. Seriously. I kept peeking out of the dressing room and giving my mom the “Are you kidding me” look, to which she’d shake her head. I suppose the only saving grace to this craziness is that Ms. ‘I’m not pregnant yet’ had also informed the entire store that her husband didn’t want to start a family until they had lowered their debt, which judging by the amount of maternity clothes she was buying, would not happen for a long time. And while she was definitely a customer, it should also be noted that there was a line of visibly uncomfortable, pregnant women waiting for a dressing room.

Like I said, it was probably one of those situations in which you had to be there, but while it was happening, it was certainly entertaining.

Words to the wise: keep your personal information to yourself, especially in a store full of strangers.

Friday, April 16, 2010

Yes, 42. That is the number of times I’ve spoken to our health insurance company since January. Yes, I’ve kept track, not only of the number of times I’ve called, but the length of each call. Most were well over an hour, or close to.

For those of you in the Foreign Service, you know that we have the choice of two health insurance companies for overseas coverage. For the purpose of this post, we shall call them Company A and Company B. We have Company B.

Overall, I’ve been very pleased with Company B. They don’t offer ANY infertility coverage (another post for another time) and yes, their rates are high, but the coverage in the U.S. is phenomenal. All of my specialists in Scottsdale, Arizona are on the “preferred provider” list and rarely do I owe much more than the copay. Happy. Overseas, Company B has caused many, many tears, panic attacks, fits of rage, etc, etc, etc.

So, why have I called Company B 42 times? In January when I booked my first appointment with the high-risk OB, his secretary explained the billing set up to me. Prenatal care (not delivery) is €4,000. The first payment of €1,000 is due at the first visit. Remaining payments of €1,000 are due at subsequent visits. Sounded fine to me, ALL of the other OBs I’d called, or our health unit had called, had similar billing practices. I called Company B and asked what paperwork I would need to be reimbursed. (For those not familiar with the Foreign Service, overseas we have to pay for all of our medical care upfront, then go after the insurance company for reimbursement. Um yeah, NOT fun). Company B told me that I would need to submit the receipts and dates. Ummm, “Are you sure”? Oh yes, I was reassured during FOUR separate phone calls. Believing this to be too easy, at the first visit/ first €1,000 payment, I asked the secretary to type up a specific letter for me to submit to Company B, clearly spelling out the payment practice. Over the next few months, Company B received the claims for three payments of €1,000, with receipts, with the standard explanation of payment given to all patients, AND with the letter written specifically for me. DENIED, DENIED, DENIED

And so began the phone calls……

First I was told, many times, that I needed CPT codes. WHAT????? I live in I.R.E.L.A.N.D; there are no CPT codes. CPT codes exist in the U.N.I.T.E.D S.T.A.T.E.S (remember, I am speaking with the “federal overseas customer service department”). After much frustration, they seem to finally believe that CPT codes indeed don’t exist in Ireland. Then I was told that I need to include dates of service. Err, did you NOT see the paperwork included that spells out the payment set up? Then I was told they wouldn’t cover “prepayment of services”. Again, did you NOT see the paperwork included?

Throughout the phone calls I have remained calm, avoided “choice” words that I sooooo felt like using, and somehow managed not to scream at anyone. I have asked for supervisors, read them the paperwork, offered to get additional letters from my doctor, letters from the embassy health unit, etc. Nope, nothing is good enough. I have tried to explain that as an American, I can’t go into another country and expect them to change their billing scheme to fit my needs. I’m paying (a lot) for “overseas coverage” and I expect to be, you guessed it, covered overseas. Then I hear, “You do have overseas coverage”. No, “I’m paying for coverage, but clearly, I’m not covered.”

As of last week, I was told to just resubmit everything after the baby is born. Err, so I’m supposed to be out almost $6,000 for several months with no guarantee of reimbursement? Don’t think so. Plus, what Company B can’t seem to grasp is that the €4,000 (roughly 6K USD based on exchange rates at the time) does NOT include delivery fees, even though all of the paperwork clearly states “does NOT include delivery fees” in BOLD letters. So then I ask, “So, if I wait until late July and submit all maternity expenses and delivery charges, I will be reimbursed”? (at least €8500+) Answer, “No, that would exceed your plan allowance”. My head is going to explode, explode I tell you. I haven't even shared with them the joyous news that I might be delivering in the U.S., I'm sure their main office of operations would internally combust upon hearing that.

Phone call after phone call has ended with tears, hanging up, and sobbing in frustration. Call Washington and ask for help you say. Been there, done that. I was told that this has never been a problem before (riiiiight), to call and speak with a supervisor, and here, try this number. I immediately tried the number and reached Company B “of Georgia”. At that point you could probably see steam coming out of my ears.

Today I’m giving myself the day off (from speaking with Company B). The ‘fun’ will resume on Monday.

Wednesday, April 14, 2010

I have been very hesitant to post on this topic because it always feels like in the next breath, something could go terribly wrong. However, it also seems unfair to keep such wonderful news from you, particularly with the amount of love, prayers, and good wishes you have sent during this very difficult journey.

While I was making arrangements to go to the U.S., I spoke to both Guinness’ private vet and his vet at UCD regarding my travel plans and apprehension about leaving him. They both assured me that whatever was wrong with Guinness was not life threatening, in that his heart wasn’t going to stop and he would die instantly. The symptoms that plagued my dear boy would not take him while I was away for nearly three weeks. Of course I was comfortable leaving him with my husband, but was nervous because I wouldn’t be around during the day to watch him. It was very difficult to walk out the front door, even with the knowledge that the cats would be well cared for, and knowing how much my husband loves them.

Once I arrived in the U.S., I called daily for updates. For the first several days, I was usually told that Guinness was eating fairly well, having an episode or two, but would usually climb into my husband’s lap and rest until he felt better (usually baby boy is in my lap in the evenings and when he doesn’t feel well). Over the next several days, my husband said that he had been episode free in the evenings, though who knows what was happening during the day when nobody was home to watch them. Days went by and Guinness’ appetite continued to improve, he was actively playing with Bella, and seemingly, episode free. I was thrilled with the news, but nervous that “normal” would return when I got back to Dublin.

When I arrived at home, Guinness ran up the stairs and stared at me cautiously through the rails on the banister. It took several minutes for him to feel safe enough to approach me. Since then, he has been nearly inseparable. I wish I could put into words the drastic change that has occurred. He is nearly 100%, back to normal. He plays, runs up and down the stairs, “talks” all the time, chases Bella, has a hearty appetite, and best of all, he has been episode free for weeks. I wasn’t sure if he would remember our routine of bedtime snacks in the evening, he does. Even better, he not only eats all of his snacks, he then climbs over and lies either on my chest or curls up next to me with his front legs and paws on my chest, often putting his face near mine to give me soft kisses on the nose. He’s quite the snugglepuss.

I don’t know what changed; perhaps the antibiotics helped after all; perhaps he is growing out of horrible symptoms that ravaged his little body for so long. One thing is certain, we couldn’t have come this far without your constant support and loving words. Thank you.

A picture from this afternoon of a very healthy and active Guinness

The fur is coming in nicely on the back of his head.

PS- Bella is doing well too. She is her normal, sassy self and seems to be enjoying that her playmate is feeling good again (the hissing and swatting have ceased). I’ll try to get some pictures of them together in the next few days.

Sunday, April 11, 2010

My mom picked me up at the airport on March 17 and the first order of business was shopping and food! We went to Babies R Us, then out for Mexican food. Oh how I had been craving Mexican food. More shopping, then we checked into the Hyatt Regency, ahhhh, a comfortable bed. It had been 20ish hours since I’d slept by that point.

The next day we took her car in for servicing and walked over to Starbucks for breakfast. My latte was PERFECT!! Before we left, I went over to thank the barista for the great drink (a rare experience at my neighborhood Starbucks in Dublin). I’m sure he either thought I was insane or I made his day. Either way, that latte was perfection in a cup. We walked back over to the Volvo dealership and by that time the courtesy driver had returned, so he took us to Mall Of America. My mom had arranged for a loaner vehicle, but none of the cars had been returned from the previous evening. The dealership offered to rent us a car, but since they couldn’t get a Volvo, it was a no-go. (My mom is a “little” protective of her only child and grandchild ;) ).

We had so much fun at the mall. The first stop was Nordstrom, of course, and my mom couldn’t help but buy lots of fun items in the children’s department for her granddaughter. Baby even managed to give a few kicks in approval of the purchases being made.

The next several days were spent in the Minneapolis area, shopping for maternity clothes, putting the registry together, and eating wonderful American food. We then went to northern Minnesota and the shopping came to a temporary halt, for which I’m sure my husband was relieved.

I actually accomplished a lot and aside from deciding on bedding (who knew it would be so hard), ordering a few more of the “big” items, and taking care of last minute things, I’m about done. YAY!

Multiple trips to Babies R Us. Who knew babies needed so much stuff?Yes, those are three different stores :/

food, glorious American food

To my cousin L, I had a cherry Icee at Sam's Club and thought of you.

No trip to the U.S. is complete without stopping at a Target.

Most of the time I didn't have the camera with me, but there were also multiple trips to Costco and I think I managed to hit every American chain restaurant in the greater Minneapolis area. Hey, I hadn't been in the U.S. in 18 months. Give me a break!

Wednesday, April 7, 2010

Once again, sorry for the lack of posts; I’ve been busy. However, the fun, shopping, and good American food eventually had to come to an end and I’m now back in Dublin. Flying at almost 22 weeks pregnant was uncomfortable, flying at almost 25 weeks was miserable, the thought of flying again at 34ish weeks. EEEEEEKKKKK! Of course it didn’t help that I was flying on one of my least favorite airlines, but it was the only carrier in which I could get a ticket from point A to point B for under $850, barely.

During the next week or so, I’ll post the highlights, and lowlights, of the trip. Hope everyone is doing well and I’m looking forward to catching up on all of your blogs!

PS- Though I was able to avoid “shooting up” during the flight on the way to the U.S., it was unavoidable on the way back to Ireland. Nothing like trying to inject 1ml of heparin into bruised, swollen, sore thighs (more on the location change later), in a tiny lavatory, in turbulence, at 30,000 feet. Good times.

Sunday, March 28, 2010

When I booked my trip to the U.S., I decided to make an appointment with a high-risk OB, for a few reasons.One: if anything were to happen while I’m here, I wanted someone to have my records and be familiar with my history.Two: I haven’t decided where I’m going to deliver, might be in Ireland, might be here, might be somewhere else.Three: while I adore my high-risk OB in Dublin, there are a few things that just aren’t “done” in Ireland and I wanted a U.S. trained physician to give me a thorough exam and advise as to whether I needed to have any additional tests, etc…

The appointment was fine and I had a chance to meet with the hospital birthing center staff, the prenatal assessment nurse, and the high-risk OB. She went over my records and we discussed the heparin. I was kind of hoping to be switched to Lovenox (only one injection per day and much less stingy, or so I’m told). The OB here said that she agreed with the fertility clinic in Dublin; I can’t be on low dose heparin (Lovenox, Clexane, or Innohep). There are just too many auto-immune issues and they are too severe, so I’m stuck with heparin and the two, stingy injections per day, oh well. She said that she would like to induce or schedule a c-section at 39 weeks, which is two weeks later than what I’ve otherwise been told, so that was good news. She also said that I’m “at much higher risk for fetal death” because of the autoimmune issues, so she will be scheduling BioPhysical Profiles every week, should I come back to the U.S. She did a very thorough exam, ultrasound, blood work, etc and everything looks great. Next week I’m scheduled to see her again, more tests and another ultrasound.

And now the big news….

When I was 16 weeks pregnant, I asked my maternal fetal medicine doctor if he could make a “guess” as to the baby’s gender. He said that it was still very early, but if he were a guessing man, he’d guess that “it’s a girl” and that he “didn’t see a penis.” LOL. Since it was so early, we didn’t want to tell very many people, just in case. When I was 21 weeks 1 day pregnant, I had the “anatomy scan”. Not knowing my doctor’s guess, the doctor doing the scan also said that it was a girl. At that point, we started telling more people. I’ve now had yet another doctor tell me that it’s definitely a girl. So there you go…

Saturday, March 27, 2010

March 17, the day that most people are trying to get to Dublin, I was getting out. That’s right, I flew to the U.S. I wasn’t terribly concerned about flying while pregnant; I was more concerned about the number of times I would need to get up. The flight wasn’t full, so the lovely woman at check in blocked the row so I would be able to get up as needed, and stretch out. That lasted until we were in the air and the guy across the aisle noticed the two empty seats next to me. He hopped over, despite me telling him that I would be getting up every 45 minutes (8 hour flight). It actually turned out fine as I wasn’t comfortable enough to sleep anyway, and he was great about getting up when I gave him “the look.” Due to the timing of the flight, I didn’t have to do my heparin injection on the plane, but instead in the women’s restroom at Newark airport. Not the ideal location, but it was okay and I rewarded myself with Starbucks. I am VERY happy to announce that they made my drink correctly, which in 18 months, hasn’t happened at the Starbucks in my neighborhood in Dublin.

The flight from Newark to Minneapolis was even less full, and on a much smaller plane. I had two seats to myself, but again, was horribly uncomfortable and much too excited by that point to rest. There was only one lavatory, which had a fairly consistent line. Eep. I kept looking back, waiting for my opportunity to pounce. I finally heard the woman across the aisle ask the flight attendant about the lavatory, which she said was once again occupied. A minute later I looked back, saw that it was empty, and sprang into action. I felt really bad about “cutting” in line, but by that time I was desperate. Upon landing, the woman across the aisle offered to get my laptop bag down from the overhead bin. Ugh, I felt horrible; I had cut ahead of a nice person. It became even worse at baggage claim when she not only approached me and asked if I needed help with my bags, I didn’t, but also wished me a pleasant evening.

Anyway, I landed in the great USA without incident and to the very kind woman sitting in 10A, my apologies for charging ahead of you to get to the lavatory.

A few weeks ago, Guinness’ fabulous, private vet, S, called. She had heard back from the feline guru in New Zealand. Her suggestion was to try Guinness on a heavy dose of antibiotics, treating him for toxoplasmosis. She was aware that he’s tested negative twice, but she’s had great success treating another toxo-negative cat in New Zealand. She also mentioned that neuro signs related to toxoplasmosis usually appear in cats Guinness’ age, so we decided to try the antibiotics.

S told me that the dose was very high and that he would likely have diarrhea, nausea, and vomiting. He was getting four pills a day (for 7 days) and took them like a champ. All was well until late that Sunday night; he started to cry around midnight. He wasn’t feeling well, which was apparent in the litter box. I got him settled down and he slept the rest of the night. Monday morning he ate, had his pills, and promptly vomited, repeat Monday night and Tuesday morning. I spoke to S and she said that we likely would have seen an improvement in the first few days, we didn’t, and that it was fine to discontinue the pills. It was definitely worth a shot, but we should have known, too easy of a fix.

He’s now having a few weeks of relaxation (no pills or injections), some time to rest his system. Hopefully in that time we will hear back from the university in the U.S. Depending on the results of that test, we have a few other meds to try. It’s so tough to wait on answers for this little guy.

Apologies for not updating in a long, long time. The anatomy scan was rescheduled for March 12 and as usual, I was 30 minutes early for the appointment. Not that I’m still bitter about not being told of the previously scheduled appointment.

The baby looks great, everything is measuring on target, and the doctor made a gender guess, consistent with what my maternal fetal medicine doctor had previously told me. More to come….

Thursday, March 11, 2010

Yep. We were told on Tuesday night that just as we suspected, Guinness does not have a thiamine deficiency. This is both good and bad news. Good because it means that I’m not completely crazy, and because Guinness can stop his daily thiamine injections. Bad because it means that we STILL don’t have a diagnosis and because as we have always suspected, it’s likely something very serious.

Next step: Our fabulous vet at UCD is sending Guinness’ urine sample to a university in the U.S. for an organic acid, urine test. It’s very expensive to do, but we are running out of tests and therefore don’t know how or even if, we should treat him.

This next test is for metabolic storage diseases. If the test is positive, we will be devastated (there is no treatment), but at least we will have a diagnosis. It will then come down to quality of life. While he’s not episode free, baby boy is doing remarkably well and is not in any pain. Both his private vet and his vet at UCD agree that there is absolutely no reason to put him to sleep right now. He’s eating, drinking, using the litter box, seeking out affection, cuddling, purring, running up and down the stairs, and has most recently started playing and wrestling with Bella again.

The episodes are brought on by stress and excitement, both good and bad. He has episodes when it’s time for treats or wet food and he has episodes when he’s frightened or at the hospital. Too bad there aren’t spa services for stressed out cats and pregnant women ;)

For now we wait for the test results from the university in the U.S. (it could take up to a month). Depending on how baby boy does in the next few weeks, we will probably try a few medications because well, why not.

Wednesday, March 10, 2010

Today I had another appointment with the MFM/OB/ Perinatologist dude. He asked how my anatomy scan went to which I replied, “I’m having it today.” To which he asked "when?", and I said, “uh now”.

It turns out that my “anatomy scan” was scheduled for last week and in a different department with a different doctor, but nobody bothered to tell me. I thought that my doctor was doing the scan, today, at the appointment that was written down in my appointment book and on my calendar at home. After a little game of back and forth regarding whether or not I was told (I wasn’t), they are going to try to get the appointment rescheduled for next week, likely at a different hospital. That will be a fun hassle to deal with.

I walked out of today’s appointment feeling sad, disappointed, and angry. Supposedly I was told of the appointment for the anatomy scan back at my first appointment in January. Now, considering that my husband was with me at the first appointment, and that we are both super organized, observant, only children who write EVERYTHING down, wouldn’t it make sense that at least one of us would have written down AND remembered the appointment? Plus, I’ve gone through two IVFs and a FET to get to this point. The anatomy scan is a major milestone; no way would I have forgotten that. Not to mention, I have NEVER in my entire life, been late to or missed a doctor’s appointment, and I’ve had a lot of them. Additionally, I was told today that there is an extra fee for this scan. I would have remembered to bring an extra bank check had I known that. RAGE

Today’s appointment was great in that the baby still has a heartbeat and looks good. The regular ultrasound machine was missing and had been replaced by what looked like an old, small laptop (no paper for pictures :( ) sitting on a rollaway cart. The image quality was um, well, ur, there really isn’t a nice way to describe it. Hopefully one of the local hospitals will be able to fit me in for a scan sometime in the next week.

To top off this lovely day, when I arrived at the pharmacy to pick up more heparin, I was told that the price had increased. Fine. Then I was told the cost. On what planet does generic heparin nearly double in price in 21 days? €66 ($90) for 10 tiny vials of heparin? Fabulous, knowing our insurance company, we’ll probably get $5 of this back.Tomorrow has to be better, right?

Actually no, please don’t. The amount of times I’ve been lied to this week (it’s only Wednesday) is baffling, absolutely baffling. And it’s bad enough to lie (HUGE pet peeve), but if you lie, and you get caught in your lie, do NOT make up more lies in an attempt to cover your original lie. Or worse, lie about something that somebody else did or said, particularly if they were also lying and you weren’t aware of it. Lastly, if you are going to lie to both a husband and wife, make sure you tell them the same lie, because they likely talk and compare notes.

I wish I could tell you that the lies don’t affect me, but they do, in a big way. Calling people on their lies or providing proof to others that these people are lying would unfortunately be detrimental, so I sit here with my mouth closed, writing a cryptic post on my blog.

Someday I will write a book, oh yes I will. Someday long after we have retired and are sitting back on the golf course, sipping fruity drinks in the warm, Arizona sun.

Saturday, March 6, 2010

Rarely have I read an article that invokes the level of anger I experienced yesterday that continues on today. I was checking one of my favorite FS (Foreign Service) blogs and was both horrified and saddened to read the author’s latest post. It appears that a man, Matthew Nasuti, who had a brief, but very troublesome relationship with the State Department has decided to write an article about FS life. Having been fired after only two weeks as a contractor and losing numerous frivolous lawsuits against the State Department, he must have felt that this was his only recourse. Fortunately several Foreign Service Officers and spouses have left comments, but that certainly doesn’t prevent the general public from believing this completely fictitious piece.

Other bloggers, particularly Digger at Life After Jerusalem, have addressed this nonsense much more eloquently than I can, but before giving you the link to the article, I will leave you with this.

The author’s comment about American diplomats living in “Embassy bubble complexes” and that the “hardships that diplomats face are therefore zero” leaves me raging. They live in embassy complexes because it’s too dangerous to live elsewhere. When my husband was in Yemen, he had to vary his routine (route and time) daily to get to work safely, not to mention the craziness of Third World traffic. In addition, he had his car searched for bombs when both arriving at work and arriving back at home. Matthew, that doesn’t sound like a hardship to you? Do you not watch the news? Have you not seen what has occurred at the embassy in Sanaa?

Then there’s the all important food (picture me rolling my eyes). “This reporter believes that most Third World countries have better tasting food than one would find in Germany or Great Britain, but to pampered diplomats, who refuse to learn the local languages and are hostile to non-European cultures, Third World countries seem confusing and inhospitable.” Err, seriously? He doesn’t see the difference between eating food in a Third World country versus Germany or Great Britain? Matthew, do we need to spell out the diseases and parasites often found in food and water in Third World countries for you? My husband had to bleach each and every fruit and vegetable he put in his mouth when he lived in Yemen, and even then he was sick for the first few months he was there, and occasionally throughout the next two years. Not to mention having to brush his teeth with bottled water.

I urge you to read the nonsense written by Matthew Nasuti , though remember his history while doing so. PLEASE take the time to read the comments below the article, left by the dedicated men and women of the Foreign Service. Also check out Digger’s post and comments. Right on!

Friday, March 5, 2010

When you receive the Happy 101 Award, you have to list 10 things that make your day and then list 10 blogs worthy of this award as well. Post a link to the blogs you nominate, and make sure you let them know that they have been nominated!

It’s been a long day, so I’m going to break the rules and do five and five.

In no particular order:

1. The cats.

2. An iced grande, nonfat latte with extra ice from Starbucks. What a perfect way to begin the day.

3. My husband.

4. Shopping in the U.S.Nordstrom, Costco, Williams-Sonoma, Trader Joes, even Safeway. What more does a girl need? Hopefully these things will be “making my day” in the very near future. Details to come!

Wednesday, March 3, 2010

After realizing last Friday that there was no way that I could traumatize Guinness with his daily thiamine injection, and his fabulous vet offering to come to the house to do it, we now have daily house calls.

When she arrived on Saturday, Guinness was shocked and looked at us as if to say, “you told her where we live?” Poor baby. He took his shot like a champ and just let out a small whimper. Nothing like the previous day’s biting, scratching, and screaming fit. His vet said that it was very helpful to see him at home, as he was walking around and acting “normal”, something they’ve never seen at the university.

Sunday, Monday, and Tuesday’s house calls were a little bit more complicated than Saturday’s. Now Guinness knows what it means when the doorbell rings at night and he runs up the stairs as fast as his little legs will carry him. One of us has to carry his wiggly little body downstairs, fluffed out tail and all. Our brave boy is doing so well with his injection that he doesn’t make a peep anymore. My husband distracts and helps to hold him, the vet holds him and injects, and I talk to him and tell him what a big, brave boy he is. Hey, it works. As soon as he’s released, he runs back up the stairs and hides under the covers on our bed. For his bravery, he’s rewarded with small bits of baked chicken, which he loves.

Unfortunately a diagnosis is still up in the air. His blood was sent to a lab in the U.K. last Monday for the thiamine test, though they claim to have just received it on Friday. His MR images have been sent to more specialists to see if they agree with the thiamine deficiency diagnosis, or possibly have a more plausible diagnosis.

Guinness’ wonderful vet from our private clinic called yesterday to check on him. I felt terrible that nobody had kept her updated (it’s been over 3 weeks since our referral to UCD). We talked for almost an hour and I emailed her Guinness’ MRI report, summary from UCD, and video of an episode. She has a colleague in New Zealand (where she’s from) that sees the most difficult cases there, so she’s going to forward all of the information and get her opinion. Thank you S!!!

For now we wait, but I’m happy to report that there has been a bit of improvement. He still has episodes with his legs and the shaking is a bit more pronounced. However he is eating fairly well, going up and down the stairs, and has used the litter box. He seeks out affection and likes to snuggle. He runs to the kitchen when he knows that it’s snack time and has been sleeping in bed with me at night, often snuggling on my chest while I read.

I know he hates his thiamine injection, but I’m so very grateful to his vet, B, for coming to the house every day to give it to him. This saves me from being the one that hurts him, she gets to see him interact and get around at home, and it saves us the trip to UCD every afternoon, which always stressed him out and brought on an episode.

Sunday, February 28, 2010

Yes ladies and gentlemen, that is liver. Though the veterinarian and I still doubt that Guinness’ problems are due to a thiamine deficiency (the MRI diagnosis from the U.K.), he is continuing to get daily thiamine injections. I want to do as much as I can for him, so I decided to supplement his diet with liver (high in thiamine).

I went to the store, found some liver, cooked it up, and guess who won’t eat it? That’s right, the two, four-legged creatures living in my house.

I can’t say that I blame them; it smells foul. Anyone need ¾ of a package of liver?

Another very well done book about infertility, written by Daniel Potter MD and Jennifer Hanin MA. The forward is by Pamela Madsen, executive director of the American Fertility Association.

The book is easy to read with a great balance of science and emotional health/ coping mixed in. Topics covered include fertility work-ups, low tech vs high tech treatment, sperm and egg donation, and surrogacy. Particularly impressive is the section on IVF. For a book that focuses on infertility as a whole versus specifically IVF, I found it to have fantastic coverage, including medications and various IVF protocols. Rounding out the book were chapters on emotions and relationships, telling versus not telling a child conceived through IVF (I’m personally a huge fan of telling), and a good glossary.

Friday, February 26, 2010

You know the one, the one that is over the top protective, disagrees with the doctor and refuses treatment

::hangs head in shame::

Yesterday Guinness was prescribed two new meds, Antepsin and Zantac, both in liquid form. These are meant to prevent stomach ulcers from the high dose of steroids he’s been getting. He takes medicine easily, for a cat, and the Antepsin went down with little fuss. The Zantac was a disaster. It smells bad, foamed, he clenched his teeth, shook his head, spit, and cried. I got .3 of the .8ml dose down his throat, threw the syringe back into the bottle and declared defeat. I’m not going to torture him. Sure enough, that amount of stress was enough to cause an episode with his legs (we’ve always suspected that it’s partially stress induced). Today I informed his vet that we would not be continuing with the Zantac. It turns out that it didn’t matter because they are discontinuing his steroids; they aren’t working :(

This afternoon Guinness had his appointment with the opthamologist. I was asked to accompany him back for the exam. The opthamologist took a complete history, asked a lot of questions, and did a VERY thorough exam (45 minutes), which was actually quite interesting. He found a few minor differences between Guinness and a healthy cat, but nothing major. Strike 20.

Toward the end of the exam, his treating veterinarian came in. I had told her that I would do Guinness’ vitamin B injections this weekend, as to avoid more trips to the university/ more stress on him. She agreed, had brought the supplies in for me and was going to do today’s injection. She and the veterinary student with her had warned me that the injection stings. NOTHING could have prepared me for what came next. The student and I held him down, his vet drew up the meds, started to inject, and he lost it. Scratching, clawing, biting, and making the most unnatural noises I’ve ever heard. I did not see a patient; I saw my helpless, scared, precious baby boy. She finished, I grabbed him, and said, "that’s it, we’re done." Tears in my eyes, blood on my hand, and my baby boy screaming. She said that he always cries during the injection, but must have been “putting on a special performance for his mother.” We discussed it and I have agreed that he can have the injections through Monday. By then we will know whether it’s working on not (I vote not). She offered to come to the house to do the injections which I said wasn’t necessary, but she insisted. I feel like such a failure. With all of my training, all of the injections I’ve given, and I can’t even give my cat an injection. Ugh, failure.

Guinness calmed down, I calmed down, and everyone left the room except the opthamologist. I was getting Guinness ready to leave when the opthamologist struck up a conversation. He mentioned something that was in the news today, which led to him talking about the building in which my husband works, which led to him figuring out why we are in Ireland, which led to him telling me about traveling all over Africa practicing veterinary medicine, which led to an interesting conversation about human medicine, and an hour later he walked Guinness and me out to the waiting area.

We are home now and both exhausted. Hopefully tomorrow’s injection will go better than today’s. Eek.

such is the life of Guinness. His highs are high and his lows are low.

He spends a great deal of his time snuggling, purring, going up and down the stairs, wanting treats, and otherwise behaving like a normal cat. Unfortunately normal is still interrupted with episodes and a lot of time at the university hospital (every afternoon).

The MRI report was less than promising. The differential diagnosis was “thiamine deficiency”, which more than left both his vet and me scratching our heads. Seriously, looking at his MR images, the radiologist came up with a vitamin B deficiency? This happens to cats that eat “inexpensive, tinned food from the store” and “raw fish”, Guinness eats Iams. He is now getting B-1 injections, because well, why not.

Should there happen to be any radiologists reading, here is the MR image interpretation:

There are two ill-defined T2 hyperintensities, 4 mm in diameter, associated with the anatomical location of the lateral geniculate nuclei, present at the dorso-lateral aspect of the thalamus (Seq 701, T2W, Image 11/22). More caudally, similar subtle T2 hyperintensities are visible within the cranial colliculus and periaqueductal gray matter. On Flair sequences, the changes are subtle. The changes are bilateral, symmetric and non-enhancing. Diffuse ill-defined patchy hyperintensities involving the hippocampus.On sagittal plane T2W sequence, The caudal occipital bone is irregular in outline, responsible for the irregular caudal margin of the cerebellum. The cerebellum appears otherwise normal in size with adequate foliation. The caudo-ventral tip of the cerebellum is triangular, often seen in otherwise normal cats. The tympanic bulla and internal ear structures are unremarkable.

Thoughts?

The more I get to know the clinicians and staff at UCD, the more I really like them. Yesterday someone had brought dessert in and two receptionists offered me a piece on different occasions. His lead vet had also emailed me a video that they had taken when Guinness was first admitted, a video that was never meant for us to see. I was touched watching the amount of affection that Guinness was shown during the six-minute clip. Every.single.time he fell over or needed to be moved, someone stroked him or patted his head. They were so gentle, and again, this was not a video that anyone ever thought that we would see. Two days in a row he has had a different nurse come out to get him. On Wednesday his nurse called him gorgeous and talked to him all the way to the clinical area. Yesterday another nurse came to get him. She too spoke to him the entire way to the door that separates the waiting area from the clinical rooms. While she was waiting for the door to open, a receptionist commented to her that Guinness was “lovely”. She agreed and gave him so many compliments. I really don’t think this was done for my benefit; I just don’t get that feeling from them. As I was leaving yesterday, a receptionist came over to ask how I was doing and to tell me how much they care about the animals that are treated at UCD, very sweet.

Since I now have the MRI report, a summary of Guinness’ clinical history, and the video clip, I’ve been searching the internet like mad for email addresses of veterinary neurologists and those teaching at veterinary schools in the U.S. I don’t expect free advice, nor do I expect a concrete diagnosis over the internet, but it can’t hurt to get his information out there. Maybe, just maybe, someone has seen a case similar to this or could suggest another test. Anything. If you know a veterinarian that might like to look at what seems like an impossible case, please email me (see upper right corner).

With that, Guinness and I are heading out the door. Time for his daily appointment. Today we have a bonus appointment with the opthamologist. Wheee……

Wednesday, February 24, 2010

Yesterday morning we picked up Guinness at the university. His vet said that he was having a good morning, had eaten breakfast, etc.. She had started him on steroids and wanted to see him later in the day to do a neuro exam. She also presented his case at rounds again. Everyone agreed that it’s a very mysterious case and that everything possible has been done (testing and treatment).

Guinness spent the day at home. He relaxed quite a bit, but also went up and down the stairs a few times, as if to say, “see mom, I’m okay, I don’t need to go back to that place.”

We took him back for his neuro exam and spoke with his vet again. She had heard back from both neurologists in the U.K. The one that she particularly likes (refers to him as the God of neurology) said that he’s never seen anything like this. His only suggestion was to send a sample of Guinness’ urine to the U.S. for a particular test. Basically providing confirmation of a Lysosomal storage disease, if that’s in fact what this is. Unfortunately there is no cure and it’s also very expensive to do, though at least we would have an answer.

Guinness is also now demonstrating some bizarre eye movement during his neuro exams, indicative of a brain disorder. The vet would like him to be seen by the opthamologist. The radiologists at the university did see something abnormal on the MRI, but it was “very subtle” and not cause for concern. We are still waiting for the official report from the radiologists in the U.K.

During his neuro exam he started having another episode. We brought him home and after resting for 30 minutes or so, he recovered. Last night he was right there when dinner was served and bedtime treats were handed out. He spent the night making the rounds, downstairs, upstairs, meowing, and sleeping. I think the best part of all was when he snuggled in bed with me, face to face, even giving me a few kisses on the nose.

Today he’s acting like a healthy, happy cat. He’s been up and down the stairs several times, used the litter box, and nibbled on some food. He spent some time snoozing on my lap, purring away. As I tried to eat my lunch, he crawled all over me trying to get at my food. He likes his water like I do, cold with ice. I added some ice cubes to his water dish and he took several sips.

This afternoon I’m taking him back to the university for his steroid injection and neuro exam. I will give the vet the update, the good and the bad.

Monday, February 22, 2010

On Saturday Guinness’ lead veterinarian called to say that he was hooked up to an IV and was showing little interest in food; they were syringing food into him. She had tried to induce an episode with his legs to take more video, but in that regard he was doing well and not having episodes. She wanted to continue to observe him through the weekend.

This afternoon a woman called to say that Guinness was eating and using the litter box. The university still hadn’t heard from the neurologists that they had sent the videos to in the U.K. They wanted to keep Guinness overnight again, not the news I wanted to hear.

Tonight Guinness’ lead vet called; the news is not good. She feels that he is continuing to deteriorate and not only are his back legs weak, his front legs are now weak too. She said that he is also somewhat reluctant to get onto his feet. As far as a diagnosis, there still isn’t one. He doesn’t fit the category for any one disease and the neurologists from the U.K. have still not been in touch; they will be called tomorrow. Guinness will be starting a high dose of steroids tonight because there really isn’t much more that can be done, so why not try it.

I expressed my desire for him to be home one more time, so we are picking him up tomorrow morning. I don’t know how long we will keep him here, probably not long. One thing is certain, my love for him and his quality of life always has and always will take precedence over my desire to have him “here” and personal selfishness. I also told the vet that I want to be there when he takes his last breath, which she agreed to. I will be cradling my baby boy as he leaves his earthly existence.

My heart is broken and my body physically hurts with pain. I can’t possibly put into words the love I have for that cat. Someday, hopefully soon, I will explain why he is more than just a pet to me, why he is so loved, so important to “his mommy.” For now I just wanted to let you know what is happening with my dear, baby boy.

I have asked the vet to summarize his history and tests as I will be immediately contacting several veterinary programs and specialists in the U.S. for more opinions. I honestly don’t expect to hear anything different than what we’ve been told here, but I need to exhaust every avenue possible for my own peace of mind.

Please pray that we will have a few good days with Guinness, and that this difficult process is as easy as possible, for all of us.

helping me pack a box a few weeks ago

Guinness loves Sundays.I like having clean, white sheets on the bed to start the week and one of Guinness' favorite things to do is "help" me make the bed every Sunday night. Of course it always takes twice as long because we spend so much time playing, but I've never regretted those extra minutes. Looking back, I'm so glad that I let him have that time every week. It was worth every minute and every black hair on the clean sheets. I love you baby boy.